The effects of coenzyme Q10 supplementation on biomarkers of exercise-induced muscle damage, physical performance, and oxidative stress: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials

Purpose: This study aims to elucidate the dose-dependent effect of coenzyme Q10 supplementation (CoQ10) on exercise-induced muscle damage (EIMD), physical performance, and oxidative stress in adults. Methods: A systematic search was conducted through PubMed, Scopus, and ISI Web of Science databases up to August 2023, focusing on randomized control trials (RCTs) that investigated the effects of CoQ10 supplementation on EIMD recovery, physical performance and oxidative stress mitigation in adults. The weighted mean difference (WMD) and 95 % confidence interval (95 %CI) were estimated using the random-effects model. Results: The meta-analysis incorporated 28 RCTs, encompassing 830 subjects. CoQ10 supplementation significantly decreased creatine kinase (CK) (WMD: −50.64 IU/L; 95 %CI: −74.75, −26.53, P < 0.001), lactate dehydrogenase (LDH) (WMD: −52.10 IU/L; 95 %CI: −74.01, −30.19, P < 0.001), myoglobin (Mb) (WMD: −21.77 ng/ml; 95 %CI: −32.59, −10.94, P < 0.001), and Malondialdehyde (MDA) (WMD: −0.73 μmol/l; 95 %CI: −1.26, −0.20, P = 0.007) levels. No significant alteration in total antioxidant capacity was observed post-CoQ10 treatment. Each 100 mg/day increase in CoQ10 supplementation was correlated with a significant reduction in CK (MD: −23.07 IU/L, 95 %CI: −34.27, −11.86), LDH (WMD: −27.21 IU/L, 95 %CI: −28.23, −14.32), Mb (MD: −7.09 ng/ml; 95 %CI: −11.35, −2.83) and MDA (WMD: −0.17 μmol/l, 95 %CI: −0.29, −0.05) serum levels. Using SMD analysis, “very large” effects on LDH and “moderate” effects on CK and MDA were noted, albeit nonsignificant for other outcomes. Conclusion: CoQ10 supplementation may be effective in reducing biomarkers of EIMD and oxidative stress in adults. Nevertheless, given the preponderance of studies conducted in Asia, the generalizability of these findings warrants caution. Further RCTs, particularly in non-Asian populations with large sample sizes and extended supplementation durations, are essential to substantiate these observations.